MANUAL OVERVIEW Recovery Clinic is a modified TC located at Bellevue Hospital Center in New York City, targeted to inner city substance abusers. The training manual for staff that follows is based on eight years of its operation. During this time period, cocaine has been the primary drug of abuse although this manual is applicable to other drugs of abuse. Members have been primarily drawn from two disenfranchised patient groups: (1) those with comorbid major psychiatric illness and (2) pregnant women and women with infants. The 9-month treatment program blends a peer leadership model with professional supervision. Members attend the program five days per week, with a full complement of treatment groups which focus on abstinence issues, management of psychiatric symptoms, life skills, and prevocational readiness.
The model of treatment is one of empowerment of the community of peers. An empowerment model requires staff to play a role of facilitation, rather than direction, of clinical activities. In a TC setting, members are expected to behave in a responsible fashion, abiding by the rules of the community (e.g., re: attendance, punctuality, dress code, use of profanity, etc.). These behavioral requirements are no different than for staff who themselves must function as role models and behave in accordance with the rules of the treatment community.
A full understanding of these guidelines is essential to knowing the precise expectations of all members, both newcomers and more senior members. It is the responsibility of staff to monitor the functioning of the community at all times and assist members in clarifying rules and determining appropriate sanctions when guidelines are violated.
The manual begins with a discussion of the treatment approach and then focuses on the primary objectives. For each objective, trainer note, content and relevant exercises are presented. We will use the term "trainee" to signify the professional audience that will be taking the course and "peer" to signify the patient population for whom this treatment approach has been developed.
